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WO2013015220A1 - Dispositif de diagnostic par rayons x et programme de commande - Google Patents

Dispositif de diagnostic par rayons x et programme de commande Download PDF

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Publication number
WO2013015220A1
WO2013015220A1 PCT/JP2012/068472 JP2012068472W WO2013015220A1 WO 2013015220 A1 WO2013015220 A1 WO 2013015220A1 JP 2012068472 W JP2012068472 W JP 2012068472W WO 2013015220 A1 WO2013015220 A1 WO 2013015220A1
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WO
WIPO (PCT)
Prior art keywords
catheter
unit
ray
treatment
image data
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/JP2012/068472
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English (en)
Japanese (ja)
Inventor
真吾 阿部
坂口　卓弥
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Toshiba Corp
Canon Medical Systems Corp
Original Assignee
Toshiba Corp
Toshiba Medical Systems Corp
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Toshiba Corp, Toshiba Medical Systems Corp filed Critical Toshiba Corp
Priority to CN201280032898.XA priority Critical patent/CN103717135B/zh
Publication of WO2013015220A1 publication Critical patent/WO2013015220A1/fr
Priority to US14/158,042 priority patent/US10631797B2/en
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
    • A61B6/12—Arrangements for detecting or locating foreign bodies
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • A61B5/316—Modalities, i.e. specific diagnostic methods
    • A61B5/318—Heart-related electrical modalities, e.g. electrocardiography [ECG]
    • A61B5/33—Heart-related electrical modalities, e.g. electrocardiography [ECG] specially adapted for cooperation with other devices
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/74—Details of notification to user or communication with user or patient; User input means
    • A61B5/746—Alarms related to a physiological condition, e.g. details of setting alarm thresholds or avoiding false alarms
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
    • A61B6/46—Arrangements for interfacing with the operator or the patient
    • A61B6/461—Displaying means of special interest
    • A61B6/463—Displaying means of special interest characterised by displaying multiple images or images and diagnostic data on one display
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
    • A61B6/50—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment specially adapted for specific body parts; specially adapted for specific clinical applications
    • A61B6/503—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment specially adapted for specific body parts; specially adapted for specific clinical applications for diagnosis of the heart
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
    • A61B6/52—Devices using data or image processing specially adapted for radiation diagnosis
    • A61B6/5211—Devices using data or image processing specially adapted for radiation diagnosis involving processing of medical diagnostic data
    • A61B6/5217—Devices using data or image processing specially adapted for radiation diagnosis involving processing of medical diagnostic data extracting a diagnostic or physiological parameter from medical diagnostic data
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
    • A61B6/52—Devices using data or image processing specially adapted for radiation diagnosis
    • A61B6/5211—Devices using data or image processing specially adapted for radiation diagnosis involving processing of medical diagnostic data
    • A61B6/5229—Devices using data or image processing specially adapted for radiation diagnosis involving processing of medical diagnostic data combining image data of a patient, e.g. combining a functional image with an anatomical image
    • A61B6/5235—Devices using data or image processing specially adapted for radiation diagnosis involving processing of medical diagnostic data combining image data of a patient, e.g. combining a functional image with an anatomical image combining images from the same or different ionising radiation imaging techniques, e.g. PET and CT
    • A61B6/5241—Devices using data or image processing specially adapted for radiation diagnosis involving processing of medical diagnostic data combining image data of a patient, e.g. combining a functional image with an anatomical image combining images from the same or different ionising radiation imaging techniques, e.g. PET and CT combining overlapping images of the same imaging modality, e.g. by stitching
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
    • A61B6/52—Devices using data or image processing specially adapted for radiation diagnosis
    • A61B6/5288—Devices using data or image processing specially adapted for radiation diagnosis involving retrospective matching to a physiological signal
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/0105—Steering means as part of the catheter or advancing means; Markers for positioning
    • A61M25/0108—Steering means as part of the catheter or advancing means; Markers for positioning using radio-opaque or ultrasound markers
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B18/1492—Probes or electrodes therefor having a flexible, catheter-like structure, e.g. for heart ablation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
    • A61B2018/00345—Vascular system
    • A61B2018/00351—Heart
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00595—Cauterization
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00636—Sensing and controlling the application of energy
    • A61B2018/00773—Sensed parameters
    • A61B2018/00839—Bioelectrical parameters, e.g. ECG, EEG
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • A61B2034/2046—Tracking techniques
    • A61B2034/2065—Tracking using image or pattern recognition

Definitions

  • Embodiments of the present invention relate to an X-ray diagnostic apparatus and a control program capable of generating support data effective for catheter treatment performed under observation of X-ray image data.
  • Medical image diagnosis using an X-ray diagnostic apparatus, an X-ray CT apparatus, etc. has made rapid progress along with the development of computer technology and has become indispensable in today's medical care.
  • X-ray image diagnosis of the circulatory region which has progressed with the development of catheter techniques, is widely used for the arteriovenous system including the cardiovascular system.
  • An X-ray diagnostic apparatus for diagnosing a circulatory region includes an X-ray generation unit and an X-ray detection unit (hereinafter collectively referred to as an imaging system), and a holding unit such as a C arm that holds the imaging system.
  • an imaging system X-ray generation unit and an X-ray detection unit
  • a holding unit such as a C arm that holds the imaging system.
  • a measurement catheter having a ring-shaped multipolar electrode is inserted into the heart chamber, for example, the myocardial potential generated at the pulmonary vein opening on the myocardial surface.
  • the treatment target site the position of the stimulation pathway between the left atrium and the pulmonary vein (hereinafter referred to as the treatment target site) that induces arrhythmia by measuring the arrhythmia.
  • the ablation is performed by bringing the distal end portion of the treatment catheter into contact with the treatment target site existing at or near the myocardial surface and supplying a high frequency current to the treatment target site via the tip provided at the distal end portion.
  • catheter ablation the arrangement of the distal end portion of the treatment catheter with respect to the treatment target site whose position is specified by the measurement catheter has been performed under observation of the image data displayed in substantially real time.
  • the present disclosure has been made in view of the above-described conventional problems, and an object of the present disclosure is to perform a suitable treatment at or near a treatment target site when performing catheter treatment on a myocardium or the like under observation of X-ray image data.
  • the position information (movement trajectory information) of the distal end portion of the measurement catheter that specifies the position of the treatment target portion detected in advance in a state where the treatment target portion is disposed is shown.
  • an X-ray diagnostic apparatus that displays image data of transmitted X-rays by irradiating X-rays on a treatment target site of a subject. Based on the data, detection means for detecting the catheter tip, storage means for storing the movement trace information of the catheter tip for at least one heartbeat based on the detection result of the detection means, and the movement trace information, It is characterized by comprising support data generating means for generating catheter treatment support data superimposed on the current image data, and display means for displaying the catheter treatment support data.
  • FIG. 1 is a block diagram showing the overall configuration of an X-ray diagnostic apparatus in the present embodiment.
  • the block diagram which shows the specific structure of the X-ray imaging part with which the X-ray diagnostic apparatus of this embodiment is provided.
  • the block diagram which shows the specific structure of the data generation part with which the X-ray diagnostic apparatus of this embodiment is provided.
  • the block diagram which shows the specific structure of the catheter front-end
  • region set in the assistance data generation mode of this embodiment The flowchart which shows the front-end
  • the myocardial potential is measured using a myocardial potential measuring catheter (hereinafter referred to as a measuring catheter) inserted into the patient's heart to thereby determine the site to be treated.
  • a myocardial potential measuring catheter hereinafter referred to as a measuring catheter
  • the distal end of the measurement catheter having the heartbeat time phase as supplementary information by performing X-ray imaging in a reference data collection mode in a predetermined heartbeat period with the position specified and the distal end portion of the measurement catheter being disposed at the treatment target site Collect position information (tip movement trajectory information).
  • treatment using the treatment catheter is not limited to the above.
  • FIG. 1 is a block diagram showing the overall configuration of the X-ray diagnostic apparatus according to the present embodiment.
  • FIGS. 2 and 3 are specific examples of an X-ray imaging unit and a data generation unit included in the X-ray diagnostic apparatus. It is a block diagram which shows a structure.
  • the X-ray diagnostic apparatus 100 shown in FIG. 1 irradiates X-rays in a reference data collection mode and a support data generation mode to an imaging region including a treatment target site of a patient 300 having an arrhythmia, and transmits the X-ray that has passed through the imaging region
  • An X-ray imaging unit 1 that detects a line and generates projection data
  • a holding unit (not shown) that holds an imaging system that performs the above-described X-ray irradiation and X-ray detection
  • a top plate 6 on which a patient 300 is placed A moving mechanism unit 7 for moving a holding unit to which an imaging system is attached, a top plate 6 on which a patient 300 is placed, and a movable diaphragm 22 provided in an X-ray generation unit 2 described later to a desired position
  • An image data generation unit 8 that generates image data using the projection data in the reference data collection mode and the support data generation mode output from the X-ray imaging unit 1, and the distal end
  • a data generation unit 9 that generates catheter treatment support data by superimposing the tip position information of the measurement catheter on the collected image data, and further includes catheter treatment support data generated by the data generation unit 9 and a warning signal described later.
  • a display unit 10 for displaying a warning signal and the like generated in the generation unit 98; input of patient information; selection of a reference data collection mode and support data generation mode; setting of X-ray imaging conditions and image data generation conditions in each mode; Input for setting catheter treatment support data generation and display conditions, inputting various instruction signals, etc. 11, and a system control unit 12 which collectively controls the respective units of the above-described X-ray diagnostic apparatus 100 has the biological signal measurement section 13 for measuring the electrocardiographic waveform and cardiac muscle potential of the patient 300.
  • the X-ray imaging unit 1 includes an X-ray generation unit 2 and an X-ray detection unit 3, a projection data generation unit 4, and a high voltage generation unit 5 that form an imaging system.
  • FIG. 2 is a block diagram illustrating a specific configuration of each of the above-described units provided in the X-ray imaging unit 1.
  • the X-ray generation unit 2 applies X-rays to the imaging region of the patient 300.
  • the movable stop 22 which forms the X-ray weight (cone beam) of the predetermined range with respect to the X-ray radiated from the X-ray tube 21 and the X-ray tube 21 is provided.
  • the X-ray tube 21 is a vacuum tube that generates X-rays.
  • the thermoelectrons generated from a heated cathode (filament) are accelerated by a DC high voltage supplied from the high voltage generator 5 and collide with a tungsten anode to cause X-rays. Is generated.
  • the movable diaphragm 22 is used for the purpose of reducing the exposure dose to the patient 300 and improving the image quality of the image data.
  • the movable diaphragm 22 narrows the X-rays emitted from the X-ray tube 21 into a predetermined irradiation area (upper blade).
  • a compensation filter that prevents halation by selectively reducing X-rays transmitted through a medium that absorbs less scattered light and a lower blade and a low-absorption amount by moving in conjunction with the diaphragm blades. Not shown).
  • the X-ray irradiation range of the support data generation mode in the present embodiment is determined by the diaphragm blades of the movable diaphragm 22 whose position is controlled based on the tip position information of the measurement catheter detected in the reference data collection mode.
  • the X-ray irradiation range is determined and limited to the treatment target portion close to the distal end portion of the measurement catheter, so that the exposure dose to the patient 300 can be reduced.
  • the X-ray detector 3 includes a method using an image intensifier and an X-ray TV and a method using a flat detector.
  • the flat detector includes a method of directly converting X-rays into electric charges, and a light once. There is a method of converting to electric charge after conversion to.
  • the X-ray detector 3 having a flat panel detector capable of directly converting X-rays into electric charges will be described, but the present invention is not limited to this.
  • the X-ray detector 3 of the present embodiment has a flat detector 31 that detects X-rays transmitted through the patient 300, and the X-rays detected by the flat detector 31 as signal charges.
  • a gate driver 32 that supplies a drive signal for reading is provided.
  • the flat detector 31 is configured by two-dimensionally arranging minute detection elements in a column direction and a line direction.
  • Each of the detection elements includes a photoelectric film that senses X-rays and generates a signal charge according to an incident X-ray dose. And a charge storage capacitor for storing the signal charge generated in the photoelectric film, and a TFT (thin film transistor) (not shown) for reading out the signal charge stored in the charge storage capacitor at a predetermined timing.
  • the projection data generation unit 4 includes, for example, a charge / voltage converter 41 that converts signal charges read in parallel in units of line direction into voltages from the flat panel detector 31 and an output of the charge / voltage converter 41. Are converted into digital signals (data elements of projection data), and a parallel / serial converter 43 that converts the digitally converted data elements into time-sequential data elements.
  • the time-series data elements output from the parallel / serial converter 43 are supplied to the image data generation unit 8.
  • the high voltage generator 5 includes a high voltage generator 52 that generates a high voltage applied between the anode and the cathode in order to accelerate thermionic electrons generated from the cathode of the X-ray tube 21, and the system controller 12.
  • X for controlling tube current, tube voltage, application time, application timing, repetition frequency of X-ray irradiation, etc. in the high voltage generator 52 based on the X-ray irradiation conditions of the reference data collection mode and support data generation mode supplied from A line control unit 51 is provided.
  • the X-ray irradiation repetition frequency in the reference data collection mode can be set higher than the X-ray irradiation repetition frequency in the support data generation mode, and the X-ray irradiation repetition frequency in the reference data collection mode can be set higher.
  • the moving mechanism unit 7 is a holding unit moving mechanism that rotates or moves a holding unit (not shown) to which the X-ray generation unit 2 and the X-ray detection unit 3 (imaging system) are attached around the patient 300.
  • a top plate moving mechanism 72 for moving the top plate 6 in the body axis direction (z direction in FIG. 1) of the patient 300 and in the directions orthogonal to the body axis (x direction and y direction in FIG.
  • a diaphragm movement mechanism 73 that moves the diaphragm blades of the movable diaphragm 22 provided in the section 2 to a predetermined position, and a movement mechanism control section 74 that controls the holding section movement mechanism 71, the top plate movement mechanism 72, and the diaphragm movement mechanism 73. It has.
  • the movement mechanism control unit 74 supplies the movement control signal generated based on the imaging system movement instruction signal supplied from the input unit 11 via the system control unit 12 to the holding unit movement mechanism 71, and the imaging system is attached.
  • the X-ray imaging position and direction are set by rotating or moving the holding unit around the patient 300.
  • the movement mechanism control unit 74 supplies the movement control signal generated based on the table movement instruction signal supplied from the input unit 11 via the system control unit 12 to the table movement mechanism 72, and
  • the center of the imaging region is set by translating 6 in the body axis direction of the patient 300 or in a direction orthogonal to the body axis.
  • the movement mechanism control unit 74 reduces the movement control signal generated based on the tip position information of the measurement catheter supplied from the tip position information storage unit 92 of the data generation unit 9 via the system control unit 12. 73, the X-ray irradiation area in the support data generation mode is brought close to the distal end of the measurement catheter by moving a plurality of diaphragm blades provided in the movable diaphragm 22 of the X-ray generator 2 to a predetermined position. Limited to the treated site.
  • the image data generation unit 8 includes a projection data storage unit (not shown), and the projection data storage unit includes a parallel serial of the projection data generation unit 4 in X-ray imaging in the reference data collection mode and the support data generation mode.
  • the data elements of the projection data output in time series from the converter 43 are sequentially stored in correspondence with the line direction and the column direction of the detection elements to generate two-dimensional image data.
  • FIG. 3 is a block diagram showing a configuration of the data generation unit 9
  • FIG. 4 is a block diagram showing a specific configuration of the catheter tip detection unit 91 provided in the data generation unit 9.
  • the data generation unit 9 includes a catheter tip detection unit 91, a tip position information storage unit 92, a tip position information extraction unit 93, an image data storage unit 94, an image processing unit 95, and a support data generation unit 96. Furthermore, a positional deviation detection unit 97, a warning signal generation unit 98, and a heartbeat time phase setting unit 99 are provided.
  • the catheter tip detection unit 91 includes, for example, a smoothing processing unit 911, a contour extraction unit 912, and a matching processing unit 913 as shown in FIG. 4, and the smoothing processing unit 911 includes a reference data collection mode and a support data generation mode.
  • a filtering process for smoothing is performed on the image data supplied from the image data generation unit 8 to remove unnecessary noise components.
  • the contour extraction unit 912 performs a filtering process or the like for contour enhancement on the smoothed image data, and displays the measurement catheter or support data generation mode indicated in the image data in the reference data collection mode. The contour of the treatment catheter indicated in the image data is extracted.
  • the matching processing unit 913 includes a template data storage unit 913a and an arithmetic processing unit 913b.
  • the template data storage unit 913a three-dimensional template data indicating the tip shapes of various catheters are stored in advance as catheter information as supplementary information.
  • the arithmetic processing unit 913b corresponds to the measurement catheter used in the reference data collection mode and the treatment catheter used in the support data generation mode from among various template data stored in the template data storage unit 913a.
  • the position information closest to the tip position information of the adjacent heartbeat time phase that has already been detected is used as the measurement catheter and the treatment for the heartbeat time phase. It is desirable to select it as the catheter tip position information.
  • the tip position information (tip movement trajectory information) of the measurement catheter based on time-series image data collected in a predetermined heart cycle (for example, one heart cycle) in the reference data collection mode is a heartbeat time phase setting described later.
  • the tip position information storage unit 92 of FIG. 3 stores the heartbeat time phase information of the patient 300 supplied from the unit 99. That is, the tip position information storage unit 92 stores tip position information (tip movement trajectory information) of the measurement catheter detected in time series in a heartbeat time phase having a time interval equal to the X-ray irradiation cycle in the reference data collection mode. Are sequentially stored with the heartbeat time phase as supplementary information.
  • the tip position information storage unit 92 is supplied with a myocardial potential measured by a later-described myocardial potential measuring unit 131 included in the biological signal measuring unit 13 and continuously receives a myocardial potential larger than a preset threshold value ⁇ . Only the tip position information of a predetermined heartbeat cycle (one heartbeat cycle) to be measured is stored together with the heartbeat time phase, and the myocardial potential is smaller than the threshold value ⁇ (that is, the tip of the measurement catheter is in contact with the treatment target site or the heart muscle The tip position information detected in the period of time) is excluded.
  • the tip position information of the treatment catheter detected based on the image data in the support data generation mode is supplied to the position deviation detection unit 97, and is used to detect the position deviation between the measurement catheter tip and the treatment catheter tip. It is done.
  • the tip position information extraction unit 93 in FIG. 3 receives the heartbeat time phase information of the patient 300 supplied from the heartbeat time phase setting unit 99 in the support data generation mode, and is the same as or closest to this heartbeat time phase.
  • the tip position information of the measurement catheter detected in the heartbeat time phase of the reference data collection mode is extracted from the various tip position information stored in the tip position information storage unit 92.
  • the image data storage unit 94 temporarily stores the image data supplied from the image data generation unit 8 in the support data generation mode, and the image processing unit 95 performs noise on the image data stored in the image data storage unit 94. Image processing for the purpose of reduction, contour enhancement, etc. is performed in substantially real time. Then, the processed image data is stored again in the image data storage unit 94.
  • the support data generation unit 96 includes a data addition unit (not shown), and the measurement catheter in the reference data collection mode supplied from the tip position information extraction unit 93 to the image data in the support data generation mode supplied from the image data storage unit 94.
  • the catheter treatment support data is generated by superimposing the tip position information. That is, the data adding unit receives the image data after the image processing supplied from the image data storage unit 94 in the support data generation mode.
  • the heartbeat time phase of the patient 300 at the time of collecting the image data extracted from the various tip position information stored in the tip position information storage unit 92 by the tip position information extraction unit 93 (the explanation will be briefly described below). Therefore, it is called the heartbeat time phase of the image data.)
  • the catheter treatment support is superposed on the image data in the support data generation mode by superimposing the tip position information of the measurement catheter having the same or closest heartbeat time phase as the accompanying information. Generate data.
  • FIG. 5 shows a specific example of the catheter treatment support data generated by the above-described support data generation unit 96.
  • this catheter treatment support data is used as the myocardial potential measurement unit 131 at its distal end portion.
  • the tip position information storage unit 92 extracts the image data in the support data generation mode in which the measurement catheters F1 and F2 having the measurement electrodes and the treatment catheter F3 having the ablation electrode at the distal end are shown. Further, it is generated by superimposing the tip position information Ax of the measurement catheter corresponding to the heartbeat time phase of the image data.
  • the positional deviation detection unit 97 of the data generation unit 9 includes a distance measurement unit (not shown).
  • the position deviation detection unit 97 is substantially omitted from the image data generation unit 8.
  • the tip position information of the treatment catheter detected by the catheter tip detection unit 91 based on the image data in the support data generation mode supplied in real time, and the heartbeat time phase of the image data supplied from the tip position information extraction unit 93 Based on the tip position information of the measurement catheter having the same or the closest heartbeat time phase as supplementary information, a positional deviation between the measurement catheter tip and the treatment catheter tip in the same heartbeat time phase is detected.
  • the distance measuring unit sets the tip position coordinates of the treatment catheter supplied from the catheter tip detecting unit 91 and the tip position coordinate of the measuring catheter supplied from the tip position information extracting unit 93 in the support data generation mode. Based on this, the distance between the catheter tips is measured.
  • the warning signal generation unit 98 includes a data comparison unit (not shown) and a warning message generation unit, and the data comparison unit compares the position shift detection result supplied from the position shift detection unit 97 with a preset threshold value ⁇ . .
  • the warning message creating unit may indicate that “the distal end portion of the therapeutic catheter is the treatment target. Create a warning message in the specified format such as “Please reset because it is far from the part.”
  • the heartbeat time phase setting unit 99 determines the heartbeat time phases in the reference data collection mode and the support data generation mode based on the electrocardiogram waveform of the patient supplied from the electrocardiogram waveform measurement unit 132 included in the biological signal measurement unit 13. Set. Specifically, first, an R wave of an electrocardiogram waveform supplied from the electrocardiogram waveform measurement unit 132 is detected, and then an interval between two R waves adjacent in the time direction (RR interval) is set to a predetermined time. A heartbeat time phase (for example, heartbeat time phases P1 to PN, which will be described later) is set by dividing by the interval ⁇ . The heartbeat time phase set in the reference data collection mode is supplied to the tip position information storage unit 92, and the heartbeat time phase set in the support data generation mode is supplied to the tip position information extraction unit 93.
  • the display unit 10 illustrated in FIG. 1 includes a display data generation unit, a data conversion unit, and a monitor (not shown), and the display data generation unit generates the catheter treatment support generated by the support data generation unit 96 of the data generation unit 9.
  • the data is converted into a predetermined display format, and further, warning text (warning signal) supplied from the warning signal generation unit 98, patient information, and the like are added as necessary to generate display data.
  • the data conversion unit performs conversion processing such as D / A conversion and television format conversion on the display data generated by the display data generation unit and displays the display data on the monitor.
  • the tip position information of the measurement catheter that constitutes the display data described above is displayed for treatment by displaying it with a color tone, brightness, transparency, etc. that are different from the image data in the support data generation mode in which the tip position information is superimposed.
  • the positional relationship with the distal end portion of the catheter becomes clear, and it becomes possible to easily correct the positional displacement of the distal end portion of the treatment catheter when an unacceptable positional displacement occurs.
  • the input unit 11 is an interactive interface including an input device such as a display panel, a keyboard, a trackball, a joystick, and a mouse.
  • the input unit 11 inputs patient information, selects a reference data collection mode and a support data generation mode, and X in each mode.
  • X-ray imaging conditions including irradiation conditions and image data generation conditions, catheter treatment support data generation conditions and display conditions, threshold values ⁇ and ⁇ , input of various instruction signals, etc. Use an input device.
  • the system control unit 12 includes a CPU and a storage circuit (not shown), and various information input / set / selected in the input unit 11 is stored in the storage circuit. Then, the CPU comprehensively controls the above-described units of the X-ray diagnostic apparatus 100 based on these pieces of information, generates image data in the reference data collection mode and the support data generation mode, and images in the reference data collection mode. Detection of measurement catheter tip position information based on the data and generation of catheter treatment support data by combining the image data in the support data generation mode indicating the treatment catheter and the above-described measurement catheter tip position information are executed.
  • the biological signal measurement unit 13 is attached to the distal end portion of a measurement catheter disposed at the myocardial treatment target site, and measures the myocardial potential generated by the treatment target site in the reference data collection mode.
  • a myocardial potential measuring unit 131 and an electrocardiographic waveform measuring unit 132 that measures the electrocardiographic waveform of the patient 300 in the reference data collection mode and the support data generation mode are provided.
  • the myocardial potential measurement unit 131 has a measurement electrode (see FIG. 5) for measuring the potential of the myocardial surface, and is provided at the distal end of a measurement catheter that is inserted into the heart of the patient 300 for the purpose of measuring the myocardial potential. It has been. Then, it is possible to specify the position of the treatment target site by measuring the myocardial potential generated at the treatment target site using the myocardial potential measurement unit 131, and the myocardial potential measured at this time has an amplitude larger than the threshold value ⁇ .
  • the tip position information of the measurement catheter in a predetermined heartbeat cycle (one heartbeat cycle) having “” is stored in the tip position information storage unit 92.
  • the electrocardiogram waveform measuring unit 132 is mounted on the body surface of the patient 300 to measure the electrocardiogram waveform, an amplification circuit that amplifies the electrocardiogram waveform measured by the measurement electrode to a predetermined amplitude, An A / D converter (not shown) for converting the amplified electrocardiogram waveform into a digital signal is provided.
  • FIG. 6A shows an electrocardiogram waveform Ec of the patient 300 measured by the electrocardiogram waveform measurement unit 132 of the biological signal measurement unit 13
  • FIG. 6B shows a heartbeat time phase setting based on the electrocardiogram waveform Ec.
  • the R wave detected by the unit 99 and the RR interval Tr shows the heartbeat time phase setting unit 99 set by dividing each of the RR intervals Tr by the time interval ⁇ . Phases P1 to PN are shown, and FIG. 6D shows the myocardial potential Fc and the threshold value ⁇ at the treatment target site of the patient 300 measured by the myocardial potential measuring unit 131 of the biological signal measuring unit 13.
  • the tip position information storage unit 92 stores a predetermined cardiac cycle after time t3 when the myocardial potential Fc in the reference data collection mode is greater than a preset threshold value ⁇ (for example, one cardiac cycle in the period [t3-t4]).
  • the tip position information of the measurement catheter in the heartbeat time phases P1 to PN detected by the catheter tip detection unit 91 is stored as the additional information on the heartbeat time phase.
  • Ha shown in FIG. 7 is an X-ray irradiation region in the X-ray imaging in the reference data acquisition mode
  • Hb indicates an X-ray irradiation region in the X-ray imaging in the support data generation mode.
  • the catheter treatment support data shown in FIG. 5 is based on image data collected by X-ray imaging in the support data generation mode having an X-ray irradiation area equivalent to the X-ray irradiation area in X-ray imaging in the reference data acquisition mode.
  • the X-ray irradiation region in the support data generation mode can be limited to the periphery of the treatment target region.
  • the movement mechanism control unit 73 of the movement mechanism unit 7 generates the movement generated based on the tip position information of the measurement catheter supplied from the tip position information storage unit 92 of the data generation unit 9 via the system control unit 12.
  • a control signal is supplied to the aperture movement mechanism 73.
  • the diaphragm movement mechanism 73 that has received this movement control signal moves each of the plurality of diaphragm blades provided in the movable diaphragm 22 of the X-ray generator 2 to a predetermined position, for example, at the time of heartbeat.
  • the X-ray irradiation region in the support data generation mode is set for a relatively narrow region Hb including the closed curve R0 indicating the distal end portion of the measurement catheter disposed at the treatment target site of phases P1 to PN.
  • the operator of the X-ray diagnostic apparatus 100 Prior to the X-ray imaging in the reference data acquisition mode, the operator of the X-ray diagnostic apparatus 100 inputs patient information at the input unit 11 and sets the X-ray imaging conditions and image data generation conditions in the reference data acquisition mode and the support data generation mode. Setting, setting of threshold ⁇ and threshold ⁇ , setting of catheter treatment support data generation conditions, selection of reference data collection mode, etc. are performed (step S1 in FIG. 8), and a predetermined portion of patient 300 placed on top 6 is placed. The measurement of the electrocardiogram waveform is started by mounting the measurement electrode of the electrocardiogram waveform measurement unit 132 (step S2 in FIG. 8). At this time, various types of information input / selected / set in the input unit 11 are stored in a storage circuit included in the system control unit 12.
  • step S3 in FIG. 8 the operator inputs an X-ray imaging start instruction signal at the input unit 11 (step S3 in FIG. 8), and this instruction signal is supplied to the system control unit 12 so that time series in the reference data collection mode is obtained. Generation of image data and detection of measurement catheter tip position information based on these image data are started.
  • the system control unit 12 that has received the X-ray imaging start instruction signal input from the input unit 11 performs X-rays in the reference data collection mode included in the X-ray imaging conditions stored in its own storage circuit.
  • An irradiation condition and an instruction signal for generating X-rays are supplied to the X-ray control section 51 of the high voltage generation section 5, and the X-ray control section 51 that receives this instruction signal receives a high voltage based on the X-ray irradiation conditions.
  • the generator 52 is controlled to apply a high voltage to the X-ray tube 21 of the X-ray generator 2.
  • the X-ray tube 21 to which the high voltage is applied starts X-ray irradiation in the reference data collection mode with respect to the imaging region including the treatment target region of the patient 300, and the X-ray transmitted through the imaging region is behind Is detected by the flat detector 31 of the X-ray detection unit 3 provided in FIG.
  • the photoelectric film of the detection elements arranged two-dimensionally in the flat detector 31 receives the X-ray transmitted through the above-described imaging region and accumulates the signal charge proportional to the X-ray transmission amount in the charge storage capacitor. .
  • the gate driver 32 to which the clock pulse is supplied from the system control unit 12 supplies the drive pulse to the TFT of the flat panel detector 31 and the signal charge stored in the charge storage capacitor is obtained. Read sequentially.
  • the read signal charge is converted into a voltage by the charge / voltage converter 41 of the projection data generation unit 4 and further converted into a digital signal by the A / D converter 42 and then parallel / serial conversion. Temporarily stored as projection data for one line in the buffer memory of the device 43.
  • the parallel / serial converter 43 reads the projection data stored in its own buffer memory serially in line units, and sequentially stores them in the projection data storage unit of the image data generation unit 8 to generate two-dimensional image data. To do.
  • the obtained image data is displayed on the monitor of the display unit 10 (step S4 in FIG. 8).
  • the operator moves the distal end portion of the measurement catheter inserted into the heart of the patient 300 together with the treatment catheter while observing the image data displayed on the display unit 10 while sequentially moving along the myocardial surface.
  • the myocardial potential occurring at the distal end is measured by the measuring catheter of the myocardial potential measuring unit 131 provided at the tip (step S5 and step S6 in FIG. 8).
  • the distal end portion of the measurement catheter is disposed at a position (treatment control site) where the measured myocardial potential amplitude is larger than a preset threshold value ⁇ during a predetermined heartbeat period (one heartbeat period).
  • the heartbeat time phase setting unit 99 of the data generation unit 9 applies the electrocardiogram waveform supplied from the electrocardiogram waveform measurement unit 132. Based on this, the heartbeat time phase P1 of the patient 300 in the reference data collection mode is set (step S7 in FIG. 8), and information on the set heartbeat time phase P1 is supplied to the tip position information storage unit 92.
  • each unit provided in the X-ray imaging unit 1 generates image data of the heartbeat time phase P1 in the reference data collection mode by the same procedure as in step S4 described above (step S8 in FIG. 8), and the data generation unit 9, the catheter tip detection unit 91 performs smoothing processing, contour enhancement processing, and matching processing using template data on the image data of the heartbeat time phase P1 supplied from the image data generation unit 8.
  • the tip position information of the catheter is detected (step S9 in FIG. 8).
  • the tip position information of the measurement catheter detected by the catheter tip detection unit 91 based on the image data of the heartbeat time phase P1 is the tip position information with the heartbeat time phase P1 supplied from the heartbeat time phase setting unit 99 as supplementary information.
  • the data is stored in the storage unit 92 (step S10 in FIG. 8).
  • the heartbeat time phase setting unit 99 performs heartbeat based on the electrocardiogram waveform of the patient 300 supplied from the electrocardiogram waveform measurement unit 132 by the same procedure.
  • the time points P2 to PN are detected, and the catheter tip detection unit 91 uses the heartbeat time phases P2 to PN image data obtained by the X-ray imaging unit 1 and the image data generation unit 8 to detect the tip position information of the measurement catheter. Is detected.
  • the obtained tip position information is sequentially stored in the tip position information storage unit 92 with the heartbeat time phases P2 to PN as supplementary information (steps S7 to S10 in FIG. 8).
  • the myocardial potential having an amplitude larger than the threshold value ⁇ has already been measured in the tip position information storage unit 92, for example, in one heartbeat period of the period [t3-t4]. Only the obtained tip position information of the measurement catheter is stored with the above heartbeat time phases P1 to PN as supplementary information.
  • the operator selects the support data generation mode in the input unit 11 (step S11 in FIG. 9), and further, the support data An instruction signal for starting X-ray imaging in the generation mode is input (step S12 in FIG. 9). Then, the instruction signal is supplied to the system control unit 12 to generate image data of the heartbeat time phase Px in the support data generation mode.
  • the system control unit 12 that has received the X-ray imaging start instruction signal from the input unit 11 includes the X-ray irradiation conditions in the support data generation mode included in the X-ray imaging conditions stored in its own storage circuit.
  • the X-ray imaging unit 1 supplies an instruction signal for generating X-rays to the X-ray imaging unit 1, and the X-ray imaging unit 1 that has received this instruction signal generates projection data generated by the same procedure as step S4 in FIG. 8 is stored in the projection data storage unit 8 to generate two-dimensional image data (step S13 in FIG. 9).
  • the image data that has undergone predetermined image processing in the image processing unit 95 is temporarily stored in the image data storage unit 94 of the data generation unit 9.
  • the heartbeat time phase setting unit 99 of the data generation unit 9 receives the electrocardiographic waveform of the patient 300 supplied from the electrocardiographic waveform measurement unit 132 in parallel with the generation of the above-described image data, and generates the electrocardiographic waveform. Based on this, a heartbeat time phase (heartbeat time phase of image data) Px at the time of generation of the image data is set (step S14 in FIG. 9).
  • the tip position information extraction unit 93 receives the information of the heartbeat time phase Px supplied from the heartbeat time phase setting unit 99 and corresponds to this heartbeat time phase Px (that is, the same heartbeat time phase Px as the heartbeat time phase Px).
  • the tip position information of the measurement catheter (detected in the phase or closest heartbeat time phase) is extracted from the various tip position information stored in the tip position information storage unit 92 (step S15 in FIG. 9).
  • the support data generation unit 96 supplies the tip position information of the measurement catheter corresponding to the heartbeat time phase Px supplied from the tip position information extraction unit 93 to the image data in the support data generation mode read from the image data storage unit 94. Is used to generate catheter treatment support data. Then, the obtained catheter treatment support data is displayed on the monitor of the display unit 10 (step S16 in FIG. 9).
  • the catheter tip detection unit 91 performs smoothing processing, contour enhancement processing, pattern matching processing, and the like on the image data of the heartbeat time phase Px supplied from the image data generation unit 8 in the support data generation mode.
  • the tip position information of the treatment catheter indicated in the data is detected (step S17 in FIG. 9).
  • the positional deviation detection unit 97 includes the tip position information of the treatment catheter detected by the catheter tip detection unit 91 based on the image data of the heartbeat time phase Px supplied from the image data generation unit 8 in substantially real time, and the tip position. Based on the tip position information of the measurement catheter corresponding to the heartbeat time phase Px of the image data supplied from the information extraction unit 93, the positional deviation between the treatment catheter tip and the measurement catheter tip in the heartbeat time phase Px. Is detected (step S18 in FIG. 9).
  • the warning signal generation unit 98 compares the positional deviation detection result supplied from the positional deviation detection unit 97 with a preset threshold value ⁇ (step S19 in FIG. 9), and the positional deviation of the catheter distal end is the threshold value. If larger than ⁇ , a warning message (warning signal) in a predetermined format is created and displayed on the monitor of the display unit 10 (step S20 in FIG. 9).
  • the operator of the X-ray diagnostic apparatus 100 who observed the warning message displayed on the display unit 10 is in the support data generation mode indicated in the catheter treatment support data displayed on the display unit 10 in step S16 described above.
  • the distal end portion of the treatment catheter is moved to the treatment target region while referring to the image data and the distal end position information of the measurement catheter detected in the reference data collection mode and superimposed on the image data (step S21 in FIG. 9).
  • the generation and display of catheter treatment support data in the heartbeat time phase Px is performed, and if the warning wording is created and displayed and the distal end of the treatment catheter is moved as necessary, the same procedure is followed.
  • Generation / display of catheter treatment support data based on the image data of the support data generation mode collected at the heartbeat time phase, creation / display of warning wording, and movement of the distal end of the treatment catheter are sequentially performed (step of FIG. 9). S13 to step S21), and further, catheter treatment based on the obtained catheter treatment support data is performed on the treatment target portion of the patient 300.
  • the data generation unit in this modification includes reference data in the heartbeat time phases P1 to PN of a predetermined heartbeat period in a state where the distal end portion of the measurement catheter for specifying the treatment target site by measuring the myocardial potential is arranged in the treatment target site.
  • Time-series image data is generated by performing X-ray imaging in the acquisition mode, and tip locus data is generated by detecting tip position information of the measurement catheter indicated in each of the image data.
  • a data generation unit 9a of the present modification shown in FIG. 10 includes a catheter tip detection unit 91, a tip position information storage unit 92, an image data storage unit 94, and an image processing unit 95 having substantially the same configuration and function as those of the above-described embodiment. And a heartbeat time phase setting unit 99, and further generates movement trajectory data (hereinafter referred to as tip trajectory data) of the measurement catheter tip based on the tip position information read from the tip position information storage unit 92.
  • tip trajectory data movement trajectory data
  • a generation unit 98a is provided.
  • the tip trajectory data generation / storage unit 90 includes a trajectory data generation unit and a trajectory data storage unit (not shown).
  • the trajectory data generation unit is detected by the catheter tip detection unit 91 and uses the heartbeat time phases P1 to PN as accessory information.
  • the tip position information of the measurement catheter stored in the information storage unit 92 is read out, and for example, tip trajectory data indicated by a curve or a closed loop is generated.
  • the obtained tip trajectory data of the measurement catheter is stored in the trajectory data storage unit.
  • the support data generation unit 96a includes a data addition unit (not shown), and the trajectory data storage of the tip trajectory data generation / storage unit 90 is added to the image data in the support data generation mode supplied from the image data storage unit 94 in substantially real time.
  • the catheter treatment support data is generated by superimposing the tip locus data of the measurement catheter supplied from the unit.
  • the positional deviation detection unit 97a includes a distance measurement unit (not shown), and when the above-described catheter treatment support data is generated in the support data generation mode, the support data generation mode supplied from the image data generation unit 8 in substantially real time. Based on the tip position information of the treatment catheter detected by the catheter tip detection unit 91 based on the image data of the above and the tip locus data of the measurement catheter supplied from the locus data storage unit of the tip locus data generation / storage unit 90 The positional deviation of the distal end portion of the treatment catheter with respect to the distal end portion of the measurement catheter (the site to be treated) is detected.
  • FIG. 11 is a diagram for explaining the positional deviation detection of the catheter distal end performed by the positional deviation detection unit 97a.
  • the closed loop R0 indicates the distal end position of the measurement catheter in the heartbeat time phases P1 to PN in the reference data collection mode.
  • the tip locus data generated by the tip locus data generation / storage unit 90 based on the information is shown.
  • B1, B2, B3,... BN indicate the position information of the distal end of the treatment catheter in the heartbeat time phases P1, P2, P3,. ing.
  • C1 on the closed loop R0 closest to the tip position information B1 is detected, and then the distance D1 between B1 and C1 is measured.
  • C2, C3,... CN on the closed loop R0 closest to the tip position information B2, B3,... BN is detected by the same procedure, and the distance D2 between B2 and C2, and the distance between B3 and C3. D3,...
  • the distance DN between BN and CN is sequentially measured.
  • the warning signal generation unit 98a illustrated in FIG. 10 includes a data comparison unit and a warning word generation unit (not shown).
  • the data comparison unit sets the distances D1 to DN supplied from the positional deviation detection unit 97a in advance. Is compared with the threshold value ⁇ .
  • the warning message creation unit creates a predetermined warning message (warning signal) and supplies it to the display unit 10.
  • the distance measurement is not limited to the method described above.
  • the tip position information of the measurement catheter and the tip position information of the treatment catheter may not necessarily match the heartbeat time phase.
  • the distance measurement unit of the positional deviation detection unit 97a performs the tip position information B1 to BN of the treatment catheter and the tip position information C1 to CN of the measurement catheter based on the heartbeat time phase information of the patient. May be detected with higher accuracy.
  • the tip position information B2 of the treatment catheter is detected at a heartbeat time phase that is an intermediate point between the heartbeat time phases P1 and P2.
  • the distance measuring unit determines a position corresponding to the heartbeat time phase of the tip position information B2 on the closed loop R0 based on the heartbeat time phases P1 to PN attached to the tip position information C1 to CN of the measurement catheter.
  • the corresponding position is the position of the intermediate point between C1 and C2.
  • the distance measurement part should just measure the distance of the front-end
  • the threshold value used for comparison by the data comparison unit may be a smaller value due to an improvement in accuracy.
  • tip locus data generation / storage provided in the data generation unit 9a is completed.
  • the trajectory data generation unit of the unit 90 reads the tip position information of the measurement catheter in the heartbeat time phases P1 to PN stored in the tip position information storage unit 92, and generates tip trajectory data indicated by a straight line or a closed loop. . Then, the obtained tip trajectory data of the measurement catheter is stored in the trajectory data storage unit of the tip trajectory data generation / storage unit 90 (step S30 in FIG. 12).
  • the support data of the data generation unit 9a is completed.
  • the generation unit 96a reads the distal locus data of the measurement catheter stored in the locus data storage unit of the distal locus data generation / storage unit 90 (step S15a in FIG. 13).
  • catheter treatment support data is generated by superimposing the tip locus data of the measurement catheter on the image data in the support data generation mode supplied from the image data storage unit 94 in substantially real time, and the obtained catheter treatment support data is obtained. Is displayed on the monitor of the display unit 10 (step S16a in FIG. 13).
  • the catheter tip detection unit 91 performs predetermined image processing on the time-series image data supplied from the image data generation unit 8 in the support data generation mode, thereby performing the therapeutic treatment indicated in the image data.
  • the tip position information of the catheter is detected (step S17 in FIG. 13).
  • the positional deviation detection unit 97a is used for treatment in a plurality of heartbeat time phases detected by the catheter tip detection unit 91 based on the image data in the support data generation mode supplied in time series from the image data generation unit 8 in substantially real time.
  • a distance (positional deviation) between the catheter tip position information and the tip locus data of the measurement catheter supplied from the tip locus data generation / storage unit 90 is detected (step S18a in FIG. 13).
  • the warning signal generator 98a compares the positional deviation supplied from the positional deviation detector 97a with a preset threshold value ⁇ (step S19a in FIG. 13). If the position deviation value is continuously greater than the threshold value ⁇ for a predetermined number of times, a predetermined warning message (warning signal) is created and displayed on the display unit 10 (step S20 in FIG. 13).
  • the operator of the X-ray diagnostic apparatus 100 who observed the warning message displayed on the display unit 10 is superimposed on the image data and the image data indicated in the catheter treatment support data displayed in step S16a described above. Based on the tip locus data of the measurement catheter being moved, the tip of the treatment catheter is moved to a position close to the treatment target site (step S21 in FIG. 13).
  • the X-ray imaging X-ray irradiation region in the generation of the image data shown in step S13 of FIG. 13 is set based on the tip locus data of the measurement catheter supplied from the tip locus data generation / storage unit 90, By setting the X-ray irradiation area in the support data generation mode to be narrower than the X-ray irradiation area in the reference data collection mode, it is possible to reduce the exposure dose to the patient 300 during catheter treatment.
  • the catheter when performing catheter treatment on the myocardium or the like under observation of X-ray image data, the catheter is previously placed in a suitable position at or near the treatment target site.
  • the position information (movement trajectory information) of the distal end portion of the measurement catheter that identifies the position of the detected treatment target portion is used as the image data in the support data generation mode in which the treatment catheter for the treatment of the treatment target portion is indicated.
  • the arrangement of the diaphragm blades provided in the movable diaphragm of the X-ray generation unit is controlled based on the tip position information of the measurement catheter, and the irradiation range of the X-ray imaging is set to the treatment target site existing in the vicinity of the tip of the measurement catheter.
  • the exposure dose to the patient can be reduced.
  • the displacement of the distal end of the treatment catheter is corrected by displaying a warning message (warning signal) created in a predetermined format. Can be performed reliably.
  • tip trajectory data is generated based on tip position information of a plurality of measurement catheters detected at a predetermined heartbeat period, and the treatment catheter indicates the obtained tip trajectory data.
  • this indication is not limited to the above-mentioned embodiment and its modification, and it can change and carry out further.
  • the treatment using the treatment catheter is not limited to the above.
  • the tip position information of the measurement catheter measured in the heartbeat time phase that is the same as or closest to the heartbeat timephase of the image data is superimposed on the image data in the support data generation mode.
  • the case where the tip locus data generated based on the tip position information of a plurality of measurement catheters measured in one heartbeat cycle is superimposed on the image data is described.
  • the trajectory data may be superimposed on the image data in the support data generation mode. According to this method, it is possible to easily grasp the moving direction and the moving range of the treatment target part in a predetermined heartbeat period and the positional relationship between the treatment target part and the distal end of the treatment catheter in the heartbeat time phase. Become. Note that the period during which the tip position information of the measurement catheter is measured is not limited to one heartbeat cycle, and may be a plurality of heartbeat cycles.
  • tip position information of the measurement catheter is detected by setting the X-ray irradiation repetition frequency in the reference data collection mode higher than the X-ray irradiation repetition frequency in the support data generation mode.
  • Tip position information excellent in continuity may be collected by interpolating the tip position information of the measurement catheter detected at the X-ray irradiation repetition frequency equivalent to the X-ray irradiation repetition frequency in the data generation mode.
  • each of the plurality of tip position information or tip trajectory data is displayed using different hue, lightness, transparency, etc., and associated with the treatment catheter tip shown in the image data in the support data generation mode. Becomes easy.
  • the warning message generated based on the positional deviation between the distal end portion of the treatment catheter and the distal end portion of the measurement catheter and the image data of the support data generation mode are displayed on the same display unit 10 . May be displayed on a display unit provided separately, or may be displayed on a display panel of the input unit 11 or the like.
  • the warning signal generated by the warning signal generation unit 98 is not limited to the above warning wording, and may be, for example, a blinking signal of a lamp, an audio signal, or the like.
  • the measurement catheter and the treatment catheter may be configured integrally.
  • the X-ray diagnostic apparatus 100 including the myocardial potential measuring unit 131 and the electrocardiographic waveform measuring unit 132 has been described, the myocardial potential measuring unit 131 and the electrocardiographic waveform measuring unit 132 are independent of the X-ray diagnostic apparatus 100. It may be provided.
  • the data generation unit 9 and the like included in the X-ray diagnostic apparatus 100 may use, for example, a computer including a CPU, a RAM, a magnetic storage device, an input device, a display device, and the like as hardware.
  • a computer including a CPU, a RAM, a magnetic storage device, an input device, a display device, and the like as hardware.
  • the system control unit 12 that controls the data generation unit 9 can realize various functions by causing a processor such as a CPU mounted on the computer to execute a predetermined control program.
  • the above-described control program may be installed in advance in the computer, or may be stored in a computer-readable storage medium or installed in the computer of the control program distributed via the network. .
  • a biplane type X-ray diagnostic apparatus includes a front-side imaging system that images a patient placed on his or her back on a tabletop from the front in order to enable simultaneous imaging in two directions.
  • a two-line imaging system is equipped with a side imaging system that images from the side.
  • the front imaging system includes, for example, a C arm supported by a stand placed on the floor, and an X-ray generation unit and an X-ray detection unit attached to both ends of the C arm.
  • the lateral imaging system includes, for example, an ⁇ arm suspended from a ceiling, an elevating mechanism provided at both ends of the ⁇ arm, an X-ray generation unit and an X-ray detection unit supported by the elevating mechanism.
  • the support data generation unit superimposes the tip position information or tip trajectory data of the measurement catheter on the image data in the support data generation mode supplied for each of the two systems of imaging systems, thereby supporting the catheter treatment of each system.
  • the display unit generates display data from each catheter treatment support data and displays the display data on the monitor.
  • FIG. 14 shows a specific example of catheter treatment support data generated in another embodiment.
  • FIG. 14 shows an example of displaying catheter treatment support data on which tip locus data is superimposed.
  • other information warning words, patient information, etc.
  • some catheter information are omitted, but the display unit may display these information.

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Abstract

L'invention porte sur une unité de génération de données (9) d'un dispositif de diagnostic par rayons X (100), qui irradie un site à traiter chez un sujet avec des rayons X et affiche des données d'image des rayons X transmis, laquelle unité comprend : une unité de détection de pointe de cathéter (91) qui détecte la pointe d'un cathéter sur la base des données d'image ; une unité de stockage d'informations de position de pointe (92) qui stocke, en tant qu'informations de trajet de déplacement, des informations de position relatives à la pointe de cathéter pour au moins un battement de cœur sur la base du résultat de détection de l'unité de détection de pointe de cathéter (91) ; et une unité de génération de données de support (96) qui génère des données de support de traitement de cathéter par superposition des informations de trajet de déplacement sur les données d'image actuelles.
PCT/JP2012/068472 2011-07-22 2012-07-20 Dispositif de diagnostic par rayons x et programme de commande Ceased WO2013015220A1 (fr)

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